HE DISCOVERY in the early 1980s that human immunodeficiency virus (HIV) could be transmitted by blood transfusion stimulated an increased interest in techniques to minimize perioperative blood transfusion. The most commonly used techniques are preoperative autologous donation, cell salvage, acute normovolemic hemodilution, and various pharmaceutical agents. In preoperative autologous donation, patients donate up to four units of blood during the 2 to 4 weeks before the surgery. This blood is stored and used perioperatively if the patient needs blood transfusion. Cell salvage devices collect blood that is shed into the operative field or into the postoperative drain. The blood is filtered and retransfused to the patient. Cell salvage devices range from very sophisticated devices that wash the blood and require an expert